Uterine lithiasis, management by hysteroscopy: Case report and literature review.

The presence of calculi inside the uterine cavity is an uncommon finding, with few cases described in the literature. Here, we present a clinical case of a 30-year-old patient with uterine lithiasis. The patient presented with 3 months of evolution, characterized by abdominal pain in the hypogastrium, with a report of transvaginal ultrasound of hematometra with suggestive images of endometrial polyps. For this reason, she was scheduled for hysteroscopy, where three lesions of hard consistency were found, with the largest 1.5 cm. Currently, due to the few cases of uterine lithiasis described, there is no explanation of how the stones are formed in the uterine cavity. The age of the patient in this case report and the absence of predisposing factors for uterine calcifications reported in the literature is striking, which leads us to propose a hypothesis of the origin of uterine lithiasis, which is related to the history of cesarean section and the presence of hematometra, such hematic retention could have predisposed to the development of calculi in this patient. Uterine lithiasis is an extremely rare entity with few published cases; therefore, further studies are necessary.

Müllerian Aplasia with Severe Hematometra: A Case Report of Diagnosis and Management in a Low Resource Setting.

BACKGROUND: Müllerian aplasia or Mayer-Rokitansky-Küster-Hauser syndrome is described as congenital absence of the proximal vagina with or without absence of the cervix and uterus, most often recognized after the onset of primary amenorrhea. CASE: An 18-year-old woman presented to a free medical clinic in Arcahaie, Haiti with primary amenorrhea, abdominal distention, and cyclic monthly abdominal pain. Physical exam was significant for uterus palpable superior to the umbilicus, absence of vagina, and rectal exam without palpable vagina or cervix. Transabdominal and transperineal ultrasound examinations did not reveal hematocolpos. Exploratory laparotomy revealed severe endometriosis with bilateral hematosalpinx, markedly distended uterus, no proximal vagina, and normal ovaries. Uterine specimen was filled with blood and no clear cervix was present. SUMMARY AND CONCLUSION: Diagnosis of vaginal and cervical agenesis is complicated in low-resource settings and treatment must be modified when subspecialty care and consistent follow-up are not available.

[Primary amenorrhea by transverse vaginal septum: a case report and review of the literature]. / Amenorrea primaria por tabique transverso vaginal inferior: reporte de un caso y revisión de la bibliografía.

The transverse vaginal septum is one of the rarest anomalies of the reproductive tract classified depending on location. It is manifested by primary amenorrhea, cyclic pain and progressive mass growth at abdominopelvic level, ultrasound and magnetic resonance imaging provides the diagnosis, location and thickness of a transverse vaginal septum, treatment is surgical. We present a case of a teenage patient with primary amenorrhea due to lower transverse vaginal septum with surgical resection and satisfactory follow-up with successful vaginal patency.

McKusick Kaufman syndrome, complications arising at puberty.

BACKGROUND: McKusick Kaufman Syndrome (MKS), a rare genetic condition, presents in the neonatal period with a classic triad of postaxial polydactyly, congenital heart disease, and hydrometrocolpos. The diagnosis is typically clinical, based on the presence of polydactyly and hydrometrocolpos. CASE: We report the case of a 13-year-old female, who was diagnosed with MKS in infancy and underwent vaginal reconstructive surgery for a urogenital sinus. She was lost to follow-up thereafter. She presented to our institution at age 13 with pyometra, pyosalpinx, and tubo-ovarian abscess due to a stenotic cervix obstructing menstrual outflow. SUMMARY AND CONCLUSION: Gynecologic follow-up is imperative in patients with history of vaginal reconstruction to monitor for hematometra from outflow obstruction to prevent life threatening secondary bacterial infections.

[Uterus Didelphys, obstructed hemivagina and ipsilateral renal agenesis as a presentation of a case of the Herlyn-Wemer-Wünderlich syndrome. Literature review]. / Utero didelfo, hemivagina obstruida y agenesia renal ipsilateral como presentación de un caso de síndrome de Herlyn-Werner-Wünderlich. Revisión de la bibliografía.

UNLABELLED: The Herlyn-Werner-Wünderlich syndrome is a rare congenital anomaly of the Müllerian ducts. Müllerian malformations result from defective fusion of the Müllerian ducts during development of the female reproductive system. These malformations are associated with an increased probability of adverse obstetric events. The syndrome is characterized by uterus didelphys with obstructed hemivagina, and ipsilateral renal agenesis. Patients with this syndrome are asymptomatic until menarche, and can follow other complications. CASE REPORT: A 12 year-old female patient presented with a clinical picture of acute abdomen and a previous history of cyclical dysmenorrhea. A diagnosis of uterus didelphys associated with right hematometracolpos was made following an exploratory laparotomy. Resection of the right obstructed hemivagina was subsequently performed using a vaginal approach. A subsequent computed tomography seen identified renal agenesis ipsilateral to the obstructed hemivagina. IN CONCLUSION: The Herlyn-Werner-Wünderlich syndrome is a rare Müllerian anomaly. The characteristics of the syndrome may result in missed diagnosis until detailed evaluation is carried out. We therefore advise clinicians to look for Müllerian duct anomalies whenever a renal malformation is discovered in a fetus or girl postnatal. Early diagnosis of the syndrome and its associated anomalies are essential to provide adequate therapy, and to reduce reproductive complications through radical treatments. Conservative treatment is effective and has a good prognosis for the patient's reproductive function.

Hematocervix y sinequia cervical: caso clínico / Hematocervix and cervical adhesion: clinical case

We report a case of hematocervix diagnosed by ultrasonography in a perimenopausal patient with no history of cervical pathology. We discuss the etiology of this alteration, usefulness of ultrasound diagnosis, its surgical treatment and its relationship with pathologies affecting some other organs and systems.

Se presenta un caso clínico de hematocervix diagnosticado por ultrasonografía en una paciente perimenopáusica sin antecedentes de patología cervical. Se discuten las causas de esta alteración, la utilidad del diagnóstico por ultrasonido, su tratamiento quirúrgico y su relación con patologías en otros órganos y sistemas.

[Hematometra & Listeria monocytogenes]. / Hematometra por Listeria monocytogenes.

The hematometra is a nosological entity that may not always be attributed to an embryonic defect of the paramesonefros; cervical-vaginal infections such as etiological possibilities due to Listeria monocytogenes (Lm), cervix malignant neoplasias, iatrogenias due to endometrial ablation with Lasser, traumatic bloody uterine curetage and because of cervical cryocoagulation or electrocoagulation are also mentioned. The case to be reported is from a woman in reproductive stage, who is 32 years old, and had menarca at the age of 13, starting her sexual life at 31, not using any method to control her fertility. When having an eight-week amenorrhea after 8 months of marriage, she visited the doctor for assumed pregnancy, within the prenatal analysis a pelvic echographic study was requested, finding out images that we concluded as hematometra, having been drained and demonstrated the presence of LM by anti-Lm antibodies, being administered Azitromicina and Espiramicina.

Diferentes actitudes frente al síndrome de Rokitansky Kustner Hauser (SRKH) / Different attitudes in front of the Rokitansky-Kustner-Hauser syndrome

Se analizó la conducta adoptada por dos pacientes con diagnóstico de SRKH que concurrieron a la sección infanto-juvenil del Servicio de Ginecología del Hospital Ignacio Pirovano, y el impacto producido sobre su sexualidad e imagen corporal. La modalidad de atención se enmarcó dentro de un enfoque interdisciplinario. Se observó que en cada uno de los casos estudiados, la evolución y pronóstico respondieron a dos patrones de comportamiento diferentes, teniendo en cuenta los valores afectivos, familiares y sociales. La resolución quirúrgica no se concretó en ninguna de las pacientes, postergándose en uno de los casos y resolviéndose por medios mecánicos en el otro

Diferentes actitudes frente al síndrome de Rokitansky Kustner Hauser (SRKH) / Different attitudes in front of the Rokitansky-Kustner-Hauser syndrome

Se analizó la conducta adoptada por dos pacientes con diagnóstico de SRKH que concurrieron a la sección infanto-juvenil del Servicio de Ginecología del Hospital Ignacio Pirovano, y el impacto producido sobre su sexualidad e imagen corporal. La modalidad de atención se enmarcó dentro de un enfoque interdisciplinario. Se observó que en cada uno de los casos estudiados, la evolución y pronóstico respondieron a dos patrones de comportamiento diferentes, teniendo en cuenta los valores afectivos, familiares y sociales. La resolución quirúrgica no se concretó en ninguna de las pacientes, postergándose en uno de los casos y resolviéndose por medios mecánicos en el otro (AU)

[The imperforate hymen. A clinical case]. / Himen imperforado. Caso clínico.

A clinical case of imperforate hymen is presented. The echography rule is emphasized.